Process for checking the function of a respiration system

ABSTRACT

The function of a respiration system, with a patient port ( 1 ) with connected inspiration branch ( 3 ) and expiration branch, is checked. A rebreathing line ( 9 ) connects the inspiration branch to the expiration branch. A reservoir ( 25 ) is connected to a reservoir port ( 27 ) in the rebreathing line. An actuatable control valve ( 29 ) is provided in the rebreathing line between the expiration branch and the reservoir port. A pressure sensor ( 33 ) is connected to the rebreathing line. A control unit ( 39 ) is connected to the control valve and to pressure sensor. The process includes closing the control valve for a preset inspiration time and opening it for a preset expiration time. The value sent by the pressure sensor is detected with the control valve opened during the expiration time and compared with a preset first threshold valve. An error message is generated when the value sent exceeds the first threshold value.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority under 35 U.S.C. §119 ofGerman Patent Application DE 10 2011 117 786.1 filed Nov. 5, 2011, theentire contents of which are incorporated herein by reference

FIELD OF THE INVENTION

The present invention pertains to a process for checking the function ofa respiration system (also known as a ventilation system) with arebreathing line and a reservoir.

BACKGROUND OF THE INVENTION

Such a respiration system is known through the instructions for use forthe “Zeus Infinity Empowered” system of Dräger Medical GmbH. Suchrespiration systems with a rebreathing line are designed, as a rule,such that based on a patient port or Y-piece, via which a patient isconnected to the respiration system, an inspiration branch and anexpiration branch are provided, whose ends located away from the patientport are connected to one another via the rebreathing line, whichextends in the housing of the respiration system. A reservoir, such as amanual breathing bag for receiving breathing gas, a CO₂ absorber and arespiration drive, preferably in the form of a radial compressor, withwhich breathing gas can be delivered into the inspiration branch, areprovided, as a rule, in the rebreathing line.

In addition, nonreturn valves, which prevent breathing gas expired bythe patient from leaving the inspiration branch and breathing from beingable to be pressed from the rebreathing line directly in the expirationbranch, are provided in the respective inspiration and expirationbranches. Finally, a control valve or positive end-expiratory pressure(PEEP) valve, which can be opened or closed by a control, is arrangedclose to the connection between the expiration branch and therebreathing line.

The control valve is closed during the inspiration phase in order toprevent breathing gas from being pressed directly again into therebreathing line by the respiration drive instead of being pressed intothe patient port. However, the control valve is opened during theexpiration phase, so that the breathing gas discharged from the patientport can flow back from the expiration branch into the rebreathing line,and this breathing gas first enters the reservoir, i.e., usually themanual breathing bag.

Breathing gas is thus drawn during normal respiration operation at firstduring the inspiration phase by means of the respiration drive from thereservoir and returned to the patient port via the inspiration branch,and the control valve is closed during this phase. The control valve isopened during the expiration phase, and the expired gas returns againinto the reservoir.

However, the problem may arise now that the reservoir or the manualbreathing bag has too small a volume. Part of the gas arriving from thepatient port is discharged now via a gaseous anesthetic escape valve(hereinafter called “NGF valve”) provided in the rebreathing line.However, the consequence of this is that an insufficient quantity of gaswill be present in the system for the next inspiration phase and thisgas must be compensated by feeding fresh gases. The respiration systemcannot now be operated in the manner actually intended, in which lattercase only a very small quantity of expensive gases must be fed anew.

SUMMARY OF THE INVENTION

Based on the state of the art, an object of the present invention istherefore to provide a process for a respiration system described in theintroduction, with which an excessively small volume of the reservoir inthe rebreathing line is reliably recognized.

This object is accomplished according to the present invention by aprocess for checking the function of a respirator with a patient port,an inspiration branch, which has a first end and a second end, as wellas a nonreturn valve, which opens when the pressure on the side of thenonreturn valve facing the second end is above that on the side of thenonreturn valve facing the first end, wherein the first end is connectedto a patient port, with an expiration branch, which has a first end anda second end, as well as a nonreturn valve, which opens when thepressure on the side of the nonreturn valve facing the first end isabove that on the side of the nonreturn valve facing the second end,wherein the first end is connected to the patient port, with arebreathing line, which connects the second end of the inspirationbranch to the second end of the expiration branch, with a reservoir,which has a variable volume with a maximum volume, and which isconnected to a reservoir port in the rebreathing line, with anactuatable control valve, which is provided in the rebreathing linebetween the second end of the expiration branch and the reservoir port,with a pressure sensor, which is connected to the rebreathing lineadjacent to the reservoir port, and with a control unit, which isconnected to the actuatable control valve and to the pressure sensor.The process comprises the following steps:

-   -   Closing of the actuatable control valve for a preset inspiration        time and    -   Opening of the actuatable control valve for a preset expiration        time, wherein        with the control valve opened during the expiration time, the        value sent by the pressure sensor is detected and compared with        a preset first threshold value, and wherein    -   a first error message is generated when the value sent exceeds        the first threshold value.

The pressure can be measured close to the reservoir by means of thepressure sensor, which is preferably provided directly at the reservoirport. When the reservoir or the manual breathing bag has a maximumvolume that is too small, an overpressure, which is detected by thepressure sensor, is generated at first during the expiration phase atthe end of an expiration stroke in this area. When this overpressure isabove a preset threshold, an error message is sent for a user, and it isclear based on the overpressure that the maximum volume of the reservoiror manual breathing bag is not sufficient.

This process can also be carried out when the respiration system has norespiration drive or this drive is switched off. However, it ispreferred for the process to be carried out with support of arespiration drive. It is, furthermore, preferred to design therespiration drive as a radial compressor.

Furthermore, the duration of the time period elapsing after thebeginning of the expiration time until the value sent by the pressuresensor exceeds a first threshold value can be measured in a preferredembodiment. The shorter this duration, the larger is the volume missingin the reservoir, so that it is possible to adapt the error message tothe degree by which the maximum volume of the manual breathing bag orreservoir is too small.

In addition, it is preferred if the value sent by the pressure sensor isalso detected with the control valve closed during the inspiration timeand compared with a preset second threshold value, in which case anerror message is generated when the value sent drops below the secondthreshold value. The fact that a negative pressure becomes establishedat the pressure sensor in case of an undersized reservoir during theinspiration phase when the total amount of gas has been removed from thereservoir by the respiration drive and already fed to the patient portthrough the inspiration branch is utilized in this mode of operation.The appearance of a negative pressure below a preset threshold valueduring the inspiration phase is thus likewise an indicator of a manualbreathing bag being selected to be too small.

The duration of the time period elapsing after the beginning of theinspiration phase until the value sent by the pressure sensor dropsbelow the second threshold value can likewise be measured in thisconnection in another preferred embodiment. This duration is likewise anindicator of the degree by which the reservoir is undersized.

In another preferred embodiment, the respiration system has a fresh gassupply, with which at least gas components absorbed during theinspiration phase can be compensated.

Finally, it is also preferred if a volume flow sensor and a pressuresensor are provided in the inspiration branch, so that the inspirationphase and the expiration phase can be monitored by the control unit.

The present invention will be explained in more detail below on thebasis of a drawing showing only a preferred exemplary embodiment. Thevarious features of novelty which characterize the invention are pointedout with particularity in the claims annexed to and forming a part ofthis disclosure. For a better understanding of the invention, itsoperating advantages and specific objects attained by its uses,reference is made to the accompanying drawing and descriptive matter inwhich the preferred embodiment of the invention is illustrated.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a schematic view showing a gas path of a respiration systemfor carrying out an exemplary embodiment of the process according to thepresent invention.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring to the drawings in particular, the respiration system shown inFIG. 1 has, at first, a patient port 1, via which a patient can beconnected to the respiration system. Patient port 1 is designed as aY-piece, from which extends an inspiration branch 3, which has a firstend 5, which is connected to the patient port 1, and a second end 7,with which the inspiration branch 3 is connected to an outlet 8 of arebreathing line 9, which is provided in the housing of the respirationsystem and which also has, besides, an inlet 10.

Finally, a nonreturn valve 11 is also provided in the inspirationbranch, this nonreturn valve being designed such that it opens only whenthe pressure on the side of the nonreturn valve 11, which side faces thesecond end 7, is higher than on the side that faces the first end 5. Itis thus ensured that breathing gas cannot flow from the first end 5 tothe second end 7 of inspiration branch 3.

In addition, a volume flow sensor 13 and a pressure sensor 15 are alsoarranged in the inspiration branch 3 in the preferred exemplaryembodiment being shown here in order to make it possible to detect thecorresponding parameters of the breathing gas flow that appear there.

The respiration system has, furthermore, an expiration branch 17, whosefirst end 19 is connected to the patient port 1 and whose second end 21is connected to inlet 10 of rebreathing line 9. In addition, a nonreturnvalve 23 is likewise provided in expiration branch 17, but thisnonreturn valve 23 is designed such that it opens only when the pressureon the side of the nonreturn valve 23, which faces the first end 19, ishigher than the pressure on the side that faces the second end 21. As aresult, the expiration branch is designed such that breathing gas canflow in it only away from patient port 1 to inlet 10 of rebreathing line9 but not the other way around.

As is also apparent from FIG. 1, a reservoir 25, which is designed as amanual breathing bag in this preferred embodiment and is connected torebreathing line 9 via a reservoir port 27, is provided in rebreathingline 9. Reservoir 25 has a variable volume with a maximum volume,wherein the volume can be increased to the maximum volume on admissionof pressure without any appreciable resistance. An actuatable controlvalve 29 (PEEP valve), which can be opened or closed electronically, isprovided in rebreathing line 9 between reservoir port 27 and inlet 10 ofrebreathing line 9. In addition, rebreathing line 9 has a respirationdrive 31 between reservoir port 27 and outlet 8, said respiration drivepreferably being a radial compressor and being able to be used togenerate a flow in rebreathing line 9 from inlet 10 to outlet 8.Finally, a pressure sensor 33, with which the pressure in therebreathing line can be measured in the area of reservoir port 27, isalso connected to reservoir port 27.

As can also be recognized from FIG. 1, a CO₂ absorber 35, with which CO2released by the patient can be absorbed, is also arranged in rebreathingline 9. Furthermore, a fresh gas supply 37 is provided, with which freshgas can be fed into rebreathing line 9. this taking place downstream ofrespiration drive 31.

To control the components of the respiration system, a control unit 39is, finally, provided, which is connected to the volume sensor flow 13,pressure sensor 15, control valve 29, pressure sensor 33 and respirationdrive 31.

To enable excess gas to be discharged from rebreathing line 9, a gaseousanesthetic escape valve (“NGF valve”) 41 is provided, which opens at apreset threshold.

The above-described respiration system operates according to the processaccording to the present invention as follows.

After an expiration phase, during which reservoir 25 in the form of amanual breathing bag has been filled, actuatable control valve 29 isclosed by control unit 39, and respiration drive 31 is operated in thispreferred exemplary embodiment during the subsequent inspiration time inorder to generate a flow in rebreathing line 9 from reservoir 25 to thesecond end 7 of inspiration branch 3, so that breathing gas is drawnthrough the CO₂ absorber 35 from reservoir 25 and fed to patient port 1.

The value sent by pressure sensor 33 during the inspiration time isdetected by control unit 39 and compared with a preset second thresholdvalue. If the value sent drops below the second threshold value, anerror message is sent. In addition, the duration of the time periodelapsing between the closing of actuatable control valve 29 and thepoint in time at which the value sent by pressure sensor 33 drops belowthe second threshold value is measured.

The second threshold value is selected to be such that a value droppingbelow this value means that a vacuum, which can be attributed to thefact that reservoir 25 has been completely emptied, even though theinspiration time has not yet been reached, has developed in the area ofreservoir port 27. The error message varies depending on the measuredduration of the time period between the beginning of the inspirationtime and the point in time at which the value drops below the secondthreshold value, a short time period indicating that the volume ofreservoir 25 is much too small, while a comparatively long time period,which is only slightly shorter than the duration of the inspirationphase, indicates that the volume of reservoir 25 is too small onlyslightly. The error message is adapted correspondingly.

Actuatable control valve 29 is subsequently opened, and respirationdrive 31 is operated at reduced capacity in the preferred exemplaryembodiment being described here, so that nonreturn valve 11 ininspiration branch 3 remains closed. Breathing gas flows during theexpiration time through expiration branch 17, control valve 29 andreservoir port 27 into reservoir 25, which is now being filledcontinuously. The pressure at reservoir port 27 is again detected bymeans of pressure sensor 33, the value sent by pressure sensor 33 iscompared in control unit 39 with a first threshold value, and an errormessage is sent when the value sent exceeds the first threshold value.

The first threshold value is selected to be such that exceeding thisvalue means that an overpressure, which comes into being due to the factthat reservoir 25 is filled completely and can be filled further only byovercoming a resistance, which is brought about, for example, by theelasticity of the manual breathing bag, develops in the area ofreservoir port 27. When this happens, the additional breathing gasarriving from the patient port is released via NGF valve 41.

However, when there is no build-up of pressure, which would exceed thefirst threshold value, in the area of reservoir port 27, this indicatesthat the volume of reservoir 25 is large enough and no error message issent.

The duration of the time period that is between the beginning of theexpiration time, i.e., the closing of control valve 29, and theexceeding of the first threshold value by the value sent by pressuresensor 33 is also measured during the expiration time. The shorter thisduration, the greater is the degree by which the maximum volume ofreservoir 25 is undersized, and the error message sent is adapteddepending on this duration.

The above-described exemplary embodiment is provided with a respirationdrive 31. However, the process according to the present invention mayalso be carried out without such a respiration drive by switching thecontrollable valve 29. It is advantageous in this case if volume sensor13 and pressure sensor 15 are present in inspiration branch 3, so thatthe corresponding parameters can be detected by control unit 39.

To check whether the volume of reservoir 25 is sufficient, it is onlynecessary to detect the pressure in the area of reservoir port 27 duringthe expiration phase to make it possible to measure a pressure beingbuilt up there, which indicates that the capacity of reservoir 25 is toosmall, so that an error message can then be sent, on the basis of whichthe human operator may possibly use another reservoir, which has thenecessary capacity.

Using the process according to the present invention, it is consequentlypossible to determine in a simple manner that a respiration system isdimensioned incorrectly. Measurement of the duration of the time periodbetween the beginning of the inspiration or expiration phase and thepoint in time at which the respective threshold value is exceeded orundershot makes it possible to determine the extent by which the volumeof reservoir 25 is too small.

While a specific embodiment of the invention has been shown anddescribed in detail to illustrate the application of the principles ofthe invention, it will be understood that the invention may be embodiedotherwise without departing from such principles.

APPENDIX List of Reference Numbers

-   1 Patient port, Y-piece-   3 Inspiration branch-   5 First end (inspiration branch)-   7 Second end (inspiration branch)-   8 Outlet of rebreathing line-   9 Rebreathing line-   10 Inlet of rebreathing line-   11 Nonreturn valve (inspiration branch)-   13 Volume flow sensor (inspiration branch)-   15 Pressure sensor (inspiration branch)-   17 Expiration branch-   19 First end (expiration branch)-   21 Second end (expiration branch)-   23 Nonreturn valve (expiration branch)-   25 Reservoir (manual breathing bag)-   27 Reservoir port-   29 Control valve-   31 Respiration drive (radial compressor)-   33 Pressure sensor (reservoir)-   35 CO₂ absorber-   37 Fresh gas supply-   39 Control unit 39-   41 Gaseous anesthetic escape valve (NGF valve)

What is claimed is:
 1. A process for checking a function of arespiration system comprising a patient port, an inspiration branch,which has an inspiration branch first end and an inspiration branchsecond end as well as an inspiration branch nonreturn valve, which openswhen pressure on a side of the inspiration branch nonreturn valve facingthe inspiration branch second end is above pressure on a side of theinspiration branch nonreturn valve facing the inspiration branch firstend, wherein the inspiration branch first end is connected to thepatient port, with an expiration branch, which has an expiration branchfirst end and an expiration branch second end as well as an expirationbranch nonreturn valve, which opens when pressure on a side of theexpiration branch nonreturn valve facing the expiration branch first endis above pressure on the side of the expiration branch nonreturn valvefacing the expiration branch second end, wherein the expiration branchsecond end is connected to the patient port, with a rebreathing line,which connects the inspiration branch second end to the expirationbranch second end, with a reservoir, which has a variable volume with amaximum volume and which is connected to a reservoir port in therebreathing line, with an actuatable control valve, which is provided inthe rebreathing line between the expiration branch second end and thereservoir port, with a pressure sensor, which is connected to therebreathing line adjacent to the reservoir port, and with a controlunit, which is connected to the actuatable control valve and to thepressure sensor, the process comprising the steps of: closing theactuatable control valve for a preset inspiration time; opening theactuatable control valve for a preset expiration time; providing a valueas output via the pressure sensor, which is connected to the rebreathingline adjacent to the reservoir port; detecting said value sent by thepressure sensor, with the actuatable control valve opened during anexpiration phase; comparing the value detected with a preset thresholdvalue; and generating an error message when the value detected exceedsthe preset threshold value.
 2. A process in accordance with claim 1,wherein: the respiration system has a respiration drive, which isarranged in the rebreathing line between the reservoir port and theinspiration branch second end; the respiration drive is operated duringan inspiration time to generate a flow in the rebreathing line from thereservoir to the inspiration branch second end; and the respirationdrive is switched off during an expiration time or is operated atreduced capacity, so that the nonreturn valve in inspiration branchremains closed.
 3. A process in accordance with claim 1, furthercomprising: measuring a duration of a time period between the opening ofthe control valve and a point in time at which the value sent bypressure sensor exceeds the preset threshold value; and varying theerror message depending on the measured duration.
 4. A process inaccordance with claim 1, further comprising: detecting a value sent bythe pressure sensor, with the actuatable control valve closed during aninspiration time; comparing the value detected, with the actuatablecontrol valve closed, with another preset threshold value; andgenerating an error message when the value detected, with the actuatablecontrol valve closed, drops below the another preset threshold value. 5.A process in accordance with claim 4, further comprising: measuring aduration of a time period between a closing of control valve and a pointin time at which the value sent by pressure sensor drops below theanother threshold value; and varying the another error message dependingon the measured duration.
 6. A process in accordance with claim 1,wherein the reservoir comprises a manual breathing bag.
 7. A process inaccordance with claim 1, wherein the respiration system has a fresh gassupply, which is connected to the rebreathing line and with which freshgas is fed into rebreathing line.
 8. A process in accordance with claim1, further comprising: providing a volume flow sensor and a pressuresensor in the inspiration branch; and detecting the pressure and avolume flow during an inspiration time and an expiration time.
 9. Aprocess in accordance with claim 1, wherein the pressure sensor isarranged at the reservoir port.
 10. A process for checking a function ofa respiration system, the process comprising the steps of: providing therespiration system with a patient port, an inspiration branch, which hasan inspiration branch first end and an inspiration branch second end aswell as an inspiration branch nonreturn valve, which opens when apressure on a side of the inspiration branch nonreturn valve facing theinspiration branch second end is above a pressure on a side of theinspiration branch nonreturn valve facing the inspiration branch firstend, wherein the inspiration branch first end is connected to thepatient port, with an expiration branch, which has an expiration branchfirst end and an expiration branch second end as well as an expirationbranch nonreturn valve, which opens when a pressure on a side of theexpiration branch nonreturn valve facing the expiration branch first endis above a pressure on the side of the expiration branch nonreturn valvefacing the expiration branch second end, wherein the expiration branchsecond end is connected to the patient port, with a rebreathing line,which connects the inspiration branch second end to the expirationbranch second end, with a reservoir, which has a variable volume with amaximum volume and which is connected to a reservoir port in therebreathing line, with an actuatable control valve, which is provided inthe rebreathing line between the expiration branch second end and thereservoir port, with a pressure sensor, which is connected to therebreathing line adjacent to the reservoir port, and with a controlunit, which is connected to the actuatable control valve and to thepressure sensor; closing the actuatable control valve for a presetinspiration time; opening the actuatable control valve for a presetexpiration time; and at least one of: detecting a value sent by thepressure sensor, with the actuatable control valve opened during anexpiration phase, comparing the value detected with a preset thresholdvalue and generating an error message when the value detected exceedsthe preset threshold value; and detecting a value sent by the pressuresensor, with the actuatable control valve closed during the inspirationtime, comparing the value detected, with the actuatable control valveclosed, with another preset threshold value and generating an errormessage when the value detected, with the actuatable control valveclosed, drops below the another preset threshold value.
 11. A process inaccordance with claim 10, wherein: the respiration system has arespiration drive, which is arranged in the rebreathing line between thereservoir port and the inspiration branch second end; the respirationdrive is operated during an inspiration time to generate a flow in therebreathing line from the reservoir to the inspiration branch secondend; and the respiration drive is switched off during an expiration timeor is operated at reduced capacity, so that nonreturn valve ininspiration branch remains closed.
 12. A process in accordance withclaim 11, further comprising at least one of: measuring a duration of atime period between the opening of a control valve and a point in timeat which the value sent by pressure sensor exceeds the preset thresholdvalue and varying the error message depending on the measured duration;and measuring a duration of the time period between the closing ofcontrol valve and the point in time at which the value sent by pressuresensor drops below the another threshold value; and varying the anothererror message depending on the measured duration.
 13. A process forchecking a function of a respiration system comprising: providing apatient port; providing an expiration branch nonreturn valve; providingan expiration branch comprising an expiration branch first end and anexpiration branch second end, said expiration branch nonreturn valveopening when pressure on a side of the expiration branch nonreturn valvefacing the expiration branch first end is above pressure on the side ofthe expiration branch nonreturn valve facing the expiration branchsecond end, wherein the expiration branch second end is connected to thepatient port; providing an inspiration branch nonreturn valve; providingan inspiration branch, which has an inspiration branch first end and aninspiration branch second end, said inspiration branch nonreturn valveopening when pressure on a side of the inspiration branch nonreturnvalve facing the inspiration branch second end is above a pressure on aside of the inspiration branch nonreturn valve facing the inspirationbranch first end, wherein the inspiration branch first end is connectedto the patient port; providing a rebreathing line, which connects theinspiration branch second end to the expiration branch second end;providing a reservoir, which has a variable volume with a maximum volumeand which is connected to a reservoir port in the rebreathing line;providing an actuatable control valve, which is provided in therebreathing line between the expiration branch second end and thereservoir port; providing a pressure sensor, which is connected to therebreathing line adjacent to the reservoir port; providing a controlunit, which is connected to the actuatable control valve and to thepressure sensor; closing the actuatable control valve for a presetinspiration time; opening the actuatable control valve for a presetexpiration time; detecting said value sent by the pressure sensor, withthe actuatable control valve opened during an expiration phase;comparing the value detected with a preset threshold value; andgenerating an error message when the value detected exceeds the presetthreshold value.
 14. A process in accordance with claim 13, wherein: therespiration system has a respiration drive, which is arranged in therebreathing line between the reservoir port and the inspiration branchsecond end; the respiration drive is operated during an inspiration timeto generate a flow in the rebreathing line from the reservoir to theinspiration branch second end; and the respiration drive is switched offduring an expiration time or is operated at reduced capacity, so thatthe nonreturn valve in inspiration branch remains closed.
 15. A processin accordance with claim 13, further comprising: measuring a duration ofa time period between the opening of the control valve and a point intime at which the value sent by pressure sensor exceeds the presetthreshold value; and varying the error message depending on the measuredduration.
 16. A process in accordance with claim 13, further comprising:detecting a value sent by the pressure sensor, with the actuatablecontrol valve closed during an inspiration time; comparing the valuedetected, with the actuatable control valve closed, with another presetthreshold value; and generating an error message when the valuedetected, with the actuatable control valve closed, drops below theanother preset threshold value.
 17. A process in accordance with claim16, further comprising: measuring a duration of a time period between aclosing of control valve and a point in time at which the value sent bypressure sensor drops below the another threshold value; and varying theanother error message depending on the measured duration.
 18. A processin accordance with claim 13, wherein the reservoir comprises a manualbreathing bag.
 19. A process in accordance with claim 13, wherein therespiration system has a fresh gas supply, which is connected to therebreathing line and with which fresh gas is fed into rebreathing line.20. A process in accordance with claim 13, further comprising: providinga volume flow sensor and a pressure sensor in the inspiration branch;and detecting the pressure and a volume flow during an inspiration timeand an expiration time, wherein the pressure sensor is arranged at thereservoir port.